Saturday, November 1, 2008

Fall has Arrived

Wow! November already. I have so many things I need to do. Decorate for Thanksgiving (although I will be working), start my Christmas shopping (Samm's Warehouse...look out), clean house (never ending job).

It's chill here...just a little touch in the air. Yesterday I got off work early enough to actually see a sunrise!!!! It was amazing. The pinks, oranges, golds and that deep deep velvet blue of the tail end of the night. I was just really amazed! Working nights, I usually don't get off work till about 9 a.m. and then I've been trying to go to the gym, so I have sunshades on most days! I got off work yesterday at 7:10. I cannot remember ever leaving work so early.

I worked ICU, and I had my vented patient fairly stable with only one drip running and Good to go for surgery. Basically had nothing to do for her except titrate the drip and chart because had explicit orders not to turn her or do anything that could dislodge the temporary pacer lines inserted through her groin into her heart. It's been awhile since I've worked with a temp pacer and I had to look some stuff up. That's ok, since I'm re-training for ICU I had "people" who could "tell" me what to do...but I'm very particular. I like to know why I'm doing what I'm doing, and how everything is suppose to work...that way if it isn't working properly I know it before it becomes a problem! The patient only understood Spanish, so I would explain everything to the daughter who would translate. The nurse "training" me didn't like me explaining so much, but you know, the family is scared...they are scared their mother is dying, they need to know what I am doing and why I am doing it. They need to know what is planned for their mom to help "fix" her heart. They don't need false hope that "everything is gonna be ok". Their mom would not be in ICU with a tube down her throat and a billion wires everywhere if she was "ok".

I can't tell them what happened to her or why it happened...she came to us from another facility...they were just lucky as hell she was actually in the hospital when she coded. She got timely well performed CPR. She is actually able to communicate a little even with a tube. If that had happened at home, she probably would have been brain-dead by the time an ambulance would have gotten to her! So, even it she is intubated, she has still got a real fighting chance at living. I cannot tell you how many times we code a patient...and even if we get a heart rhythm and vent them for breathing, how many times it is just delaying death by only a few hours. This lady...she is aware of where she is, she can nod her head to questions, she was mouthing her daughters name when she was out of the room, she was following simple commands. I hope her surgery went well, I think she is going to be one of the lucky ones!


Reddirt Woman said...

I think that you're very caring to take the time to explain what is going on to the family, irregardless of what your 'trainer' said. As you more than well know when people are in ICU their family is scared to death and it is all unfamiliar and frightening. My sis is a pediatric nurse practitioner in the Ft. Worth area and she went back to school in her late 50's for medical Spanish so she could converse with the mothers and grandmothers, etc. that care for the children so she could be sure that they understood the directions for the meds, etc.

I tell you the same as I tell her, you have extra stars in your crown for the work you do.

Thanks... great post and I'm glad you got to see a sunrise.


Debbie Y. said...

You keep doing just what you are doing, to heck with the "trainer." She needs to be trained in the art of tactfulness, caring and respect. I don't like when nurses come into the hospital room and start some procedure without telling me what they are doing to me or my loved ones. Heck yeah we're scared. I wonder what that "trainer" nurse would have done if that was her loved one and she didn't understand what was going on. Keep on keeping on. Glad you got to see a sunrise. I like waking up early and listening to my rooster crow and watching the sunrise drinking hot cocoa.

Strong One said...

I would agree. Never stop taking that precious time to explain and talk with the patient and/or family about any and all of their concerns. It will make everything and everybody at least feel a little more in control of the uncontrollable experience they are all having.
Keep up the great work.

Aleta said...

I appreciate that you wanted the family to know. It's so hard, not knowing. I remember waiting in the Trauma room when Greg was hit head on by a lady coming from the opposite direction. We didn't know anything, just that they were running tests. One lady came in and started telling us. Oh, it was horrible knowing, but at least it gave us a chance to be prepared, to pray, to have that knowledge...